Dial Down the “Pressure” of Menopause
Keywords: menopause, menopause health, women’s health, perimenopause, post-menopause, hypertension, estrogen loss, estrogen imbalance, hormones, hormonal imbalance, high blood pressure, heart disease
December 1, 2024
Have you noticed your blood pressure rising with each annual wellness check? You're not alone. A staggering 75% of women in the U.S. aged 60 and older are hypertensive, a significant increase from the 25% of women ages 18-50. A rise in blood pressure is common in menopausal women. But what causes it? Are hormone changes to blame? And what can we do to dial down blood pressure after menopause through diet? The answers are crucial because, on average, women spend 1/4 of their lives in post-menopause. By understanding how hormone changes contribute to rising blood pressure, you can improve your heart health and ensure you thrive throughout what traditional Chinese health care calls a woman's “second spring."
What Causes High Blood Pressure in Menopause?
Heart disease is the leading cause of death in women and men, and high blood pressure, though mostly symptom-free, is the main risk factor for the disease. Blood pressure is typically lower in women than in men before menopause. But, after menopause, the prevalence of hypertension in women exceeds men.
So, why are midlife women facing higher levels of hypertension? It turns out estrogen is the secret superpower behind women’s heart health.
Your Heart On + Off Estrogen
Estrogen is a hormone that flows through the female body from puberty to menopause. In the past, doctors believed that estrogen's main role was to regulate the menstrual cycle. However, with increased focus on women's research in recent decades, science has unveiled many of estrogen's functions beyond baby-making. Estrogen supports nearly every tissue and organ in the body, including the heart and blood vessels. Research suggests that the normal loss of estrogen during menopause increases the risk of high blood pressure by two-fold, even after accounting for factors like age and weight gain.
Estrogen protects women's hearts and helps control blood pressure in several ways:
It helps regulate cholesterol by decreasing LDL (the “bad” type) and increasing HDL (the “good” type).
It helps keep blood vessels supple.
It works as a powerful antioxidant in the body, scooping up free radicals that can damage blood vessel walls.
It helps control belly fat, which can lead to a higher risk of high blood pressure.
Your Backup Superpower --- Diet
The good news is that you have another superpower at your fingertips (and at your utensil tips). Anti-inflammatory diets such as the Mediterranean diet, DASH diet, and a plant-based diet are all shown to reduce the risk of high blood pressure and help manage some of its risk factors like weight gain and cholesterol levels, regardless of age or estrogen levels. These diets contain few processed foods and are rich in heart-protective antioxidants. Here are just a few superpower players that pack a punch against hypertension.
1. Potassium
Potassium is a mineral that helps with fluid balance, supports healthy blood pressure, and reduces bloating. Many veggies provide a rich source. Never take potassium tablets unless directed by your doctor, as they can interact with certain medications and cause health problems.
Amount: 2900 mg/day. A baked potato with the skin has about 900 mg.
Good Sources: Potatoes, squash, raisins, prunes, soybeans, lentils, bananas, seeds, nuts, and kale, to name a few.
2. Fiber
A high-fiber diet helps manage appetite, reduces the risk of weight gain, and contributes to gut health, producing short-chain fatty acids that support heart, lung, and brain health.
Amount: At least 3 servings/day of high-fiber foods.
Good Sources: Whole grains - 1 slice of whole grain bread, 1 cup whole grain, unsweetened cereal, 1/2 cup of brown rice, quinoa, farro, oatmeal (rolled oats or steel cut), etc. Other great sources include whole fruits, veggies, and beans.
3. Beans
Several studies link eating legumes (beans and lentils) with lower odds of high blood pressure. In one large cohort study, middle-aged women eating 1/2 cup of cooked beans daily were 36% less likely to have hypertension than those who did not eat legumes, even after adjusting for lifestyle factors like age, smoking, and physical activity. Start slowly to avoid gastric upset and work up to 1 serving daily.
Amount: 1/2 cup/day cooked.
Best Sources: Soybeans (including edamame and tofu), black beans, white beans, lentils, peas, chickpeas, kidney beans, mung beans, and peanuts.
4. Fruits and Veggies
In addition to being high in fiber, fruits and veggies are loaded with good vitamins and minerals that are shown to be heart-protective. And there's a bonus: eating more produce can help temper hot flashes, enhance sleep, lower rates of depression, and support weight control.
Amount: At least 2 servings of fruit and 3 servings of vegetables daily, about 1 medium piece of fruit) 1/2 chopped veggies or fruit or 1 cup of raw leafy greens.
Good Sources: Leafy greens, bok choy, kale, broccoli, yams, potatoes, jackfruit, kiwi, apples, mango, bell peppers, pumpkin and many more.
6. Omega 3
There is ample proof that omega-3 fatty acids reduce the risk of hypertension. According to a research review published in the Journal of the American Heart Association, the optimal daily dose to help lower blood pressure is about 3 grams of omega-3, consumed in foods or supplements.
Amount: 3-5 grams/day. A single salmon fillet has about 5 grams. A handfull of flax seeds has about 3 grams.
Best Sources: Fish, flax seeds, seaweed, and walnuts.
7. Calcium
While the research is still mixed, some studies have found that upping calcium intake lowered blood pressure by as much as 2 points, mainly in people who have hypertension. This may not seem like a lot, but even small reductions in blood pressure can lower your risk of heart disease. Another side effect of estrogen loss is reduced calcium absorption, which leads to bone loss. All the more reason to make sure you are getting enough.
Amount: 1100-1500 mg/day. For reference, one 8 oz glass of milk equals 300 mg of calcium.
Best Sources: Milk, low-fat yogurt, kefir, soft cheese, tofu, and it is added to foods like orange juice and non-dairy milk.
8. Dial Down Sodium
Diets high in sodium are linked to high blood pressure. The biggest culprits are processed foods and restaurant foods. Preparing your meals at home without using a lot of pre-packaged foods or added table salt will allow you to control how much sodium you get. If recipes call for salt, consider replacing it with your tasty herbs or spices.
Amount: Less than 2,300 mg daily or about one teaspoon of salt. And less than 1,500 mg daily or 2/3 teaspoon for hypertensive people.
Embrace the Change
The "second spring" refers to a blossoming that women step into after menopause. It can be a liberating time of rebirth and self-discovery. Staying active, meditation, yoga, getting enough sleep, spending time with loved ones, and doing things you enjoy are all shown to reduce stress, lower inflammation, lower disease risk, improve quality of life, and help manage blood pressure throughout all phases of menopause. If high blood pressure persists, know that you are not alone and that there are factors beyond your control. Talk with your doctor about your options.
Bottom Line
Color your plate with a wealth of fruits, veggies, whole grains, beans and lentils, seeds, nuts, herbs and spices. Cook with friends. Keep moving. Stay tuned in to your body’s signals. And create new healthy habits by making small changes that you can stick with over time. Most importantly, embrace the change, and you will ‘pause well.’
Author: Stacee Nault, American University MSNE student and the Pause Well Program creator
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